Upper Extremity Functional Index Research Articles

Effects of computer use on upper limb musculoskeletal disorders and function in academicians

Objectives. This study aimed to investigate the effects of academician’s demographic characteristics and computer usage habits on upper limb musculoskeletal disorders (MSDs) and function. Methods. A cross-sectional observational study was conducted with 100 academicians. Data were collected using questionnaires, which included the patient-rated wrist evaluation questionnaire – Turkish version (PRWE-T), the Cornell musculoskeletal discomfort questionnaire – Turkish version (CMDQ-T), the upper extremity functional index – Turkish version (UEFI-T), demographic characteristics and average daily computer usage time. Results. A low-level significant correlation was found between the age of the individuals and the CMDQ-T forearm (p = 0.044; r = 0.202) and CMDQ-T wrist (p = 0.001; r = 0.337) scores. Women had higher CMDQ-T neck scores and lower UEFI-T scores than men (p < 0.05). Academicians who used computers for 6 h a day or more had higher PRWE-T and CMDQ-T neck, shoulder, upper arm and forearm scores, and had a lower UEFI-T score (p < 0.05). Conclusion. Neck, shoulder, upper arm and forearm symptoms were higher and upper extremity function was impaired in academicians who used computers for 6 h a day or more. Besides, gender and age were associated with upper limb MSDs and function, but occupation duration did not affect those outcomes in academicians.

Self-perceived upper extremity motor function predicts health-related quality of life in chronic stroke survivors

Purpose To examine whether the Upper Extremity Functional Index (UEFI) score independently contributes to the Stroke Impact Scale (SIS) score and quantified its relative contribution to SIS scores in chronic stroke survivors. Materials and methods A cross-sectional study in a university-based rehabilitation centre with people with chronic stroke (N = 95) aged ≥ 50 years. The outcome measures included paretic hand grip strength, Fugl–Meyer Upper Extremity Assessment (FMA-UE), Wolf Motor Function Test (WMFT), UEFI, and SIS. Results Correlation analysis revealed that paretic hand grip strength, FMA-UE, UEFI, and WMFT scores exhibited a significant moderate positive correlation with SIS scores (r = 0.544–0.687, p < 0.001). The results of a regression model indicated that after adjustment for demographic factors and stroke-related impairments, the UEFI scores remained independently associated with SIS scores, accounting for 18.8% of the variance. The entire model explained 60.3% of the variance in SIS scores. Conclusions Self-perceived UE motor function is a crucial component to be included in rehabilitation programmes aimed at enhancing quality of life and participation among chronic stroke survivors.

THE EFFECTS OF TRANSCUTANEOUS AURICULAR VAGUS NERVE STIMULATION ON NERVE CONDUCTION VELOCITY, GRIP STRENGTH, PAIN, AND UPPER EXTREMITY FUNCTIONALITY IN INDIVIDUALS WITH CARPAL TUNNEL SYNDROME

Purpose: This study aims to investigate the effects of transcutaneous auricular vagus nerve stimulation (taVNS) on key parameters, including nerve conduction velocity, grip strength, pain, and upper extremity functionality in individuals with carpal tunnel syndrome (CTS). Methods: The study involved 51 patients (90 hands) diagnosed with carpal tunnel syndrome, comprising 12 males and 39 females, ranging in age from 18 to 58 years. Participants were divided into groups by random randomization method. Sensory branch conduction velocity of the median nerve was assessed via electromyography (EMG), hand grip strength was measured using a digital dynamometer, and pain intensity was quantified with a visual analog scale (VAS); additionally, upper extremity functionality was evaluated using the Upper Extremity Functional Index (UEFI) scale before and after the treatment. In the experimental group, in addition to the conventional physiotherapy program, 10 sessions of auricular vagus nerve stimulation were administered; for the sham and control groups, the conventional physiotherapy program alone was conducted over the course of 10 sessions. Results: The analysis revealed no statistically significant differences between the groups concerning variables such as body mass index (BMI), age, gender, educational background, and smoking status (p&gt;0.05). However, within-group evaluations exhibited significant differences compared to baseline values in terms of nerve conduction velocity, pain perception, and upper extremity functionality, with no such difference observed in grip strength (p

Smartwatch-based functional assessment for upper extremity impairment after musculoskeletal injuries: A pilot study

Introduction Wearable sensors are increasingly applied to rehabilitation for arm movement analysis. However, simple and clinically relevant applications are scarce. Objectives To investigate the feasibility of single smart watch-based parameters for functional assessment in upper limb rehabilitation for musculoskeletal injuries using a commercial smart watch. Method Ten patients with unilateral shoulder pain and range-of-motion limitations were enrolled. They wore Galaxy Watch® and performed three sets of upper extremity tasks consisting of gross activities-of-daily-living tasks, Wolf Motor Function Test (WMFT), and Upper Extremity Functional Index (UEFI), and the acceleration and angular velocities were acquired. The motion segment size (MSS), representing motion smoothness from a clinical perspective, and various sensor-based parameters were extracted. The correlation between the parameters and clinical outcome measures were analyzed. The percent relative range (PRR) of the significant parameters was also calculated. Results For overhead and behind body activity task set, mean MSS for elbow flexion/extension axis significantly correlated with WMFT score (R = 0.784, p = .012). For planar tasks, mean MSS for the forearm supination/pronation (R = 0.815, p = .007) and shoulder rotation (R = 0.870, p = .002) axes significantly correlated with WMFT score. For forearm and fine movement task set, mean MSS of the elbow flexion/extension angle showed significant correlation with WMFT (R = 0.880, p &lt; .001) and UEFI (R = 0.718, p = .019). The total performance time (R = −0.741, p = .014) also showed significant correlation with WMFT score. The PRR for mean MSS in forearm supination (71.5%, planar tasks) and mean MSS in x-direction (49.8%, forearm and fine motor movements) were similar to the PRR of WMFT (58.5%), suggesting sufficient variation range across different degree of impairments. Conclusion The commercial smart watch-based parameters showed consistent potential for use in clinical functional assessments.

Structural Validity of the Arabic Upper Extremity Functional Index Using Exploratory and Confirmatory Factor Analysis

The upper extremity functional index (UEFI) is a commonly used patient-reported outcome measure with good measurement properties. The Arabic UEFI has been reported to have sufficient reliability and construct validity, but its structural validity has not been examined yet. The aim of this study was to examine the structural validity of the Arabic UEFI using both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) in patients with upper extremity musculoskeletal disorders. Participants with upper extremity musculoskeletal disorders attending physical therapy clinics were recruited. Participants were asked at their initial visit to physical therapy to complete the Arabic versions of the UEFI, and the numeric pain rating scale. In the EFA, the number of factors was determined using parallel analysis and maximum likelihood was used for extraction. The fit of the structural model identified using EFA was examined using CFA with multiple fit indices. The results of the EFA suggested one factor structure accounting for 57.22% of the total variance. All the UEFI items showed substantial loadings on the single factor that ranged from 0.51 to 0.85. The CFA multiple fit indices did not support the fit of the unidimensional structure at the first run of the analysis. Adding error covariance to items of similar function led to good fit of the data to the modified unidimensional model; χ2 = 665.94 (df = 162, P &lt; 0.001), χ2/df = 2.88, Tucker–Lewis index (TLI) = 0.91, comparative fit index (CFI) = 0.92, root mean square error of approximation (RMSEA) = 0.086 (90% CI = 0.077-0.095), and standardized root mean residual (SRMR) = 0.045. The results of the EFA supported this unidimensional structure of the UEFI while the CFA supported this unidimensional structure after accounting for possible response dependency among some of the items. Clinicians and researchers can use one total score for the Arabic UEFI that reflects the level of upper extremity function.

Enhancing Upper Limb Recovery and Reducing Stress and Anxiety Through Non-Immersive Virtual Reality in Subacute and Chronic Stroke Survivors: An Experimental Study

Introduction: Stroke is the third-leading cause of major long-term disability and the second-leading cause of mortality worldwide. Paralysis, paresis (muscle weakness), spasticity, difficulty walking, difficulty controlling motions, and limb discomfort are frequent limb impairments. Nearly 80% of stroke survivors are affected. Stroke survivors suffer with physical disabilities in addition to a reduced quality of life in terms of their health, a higher degree of worry, and a loss of independence. With a prevalence of 55% to 75%, hand motor deficits are the most prevalent post-stroke.1 The most common impairment is motor dysfunction, which affects 90% of stroke survivors with some kind of upper limb motor disability. Motor dysfunction is a strong indicator of poor functional recovery. The most typical post-stroke symptom is hemiparesis.1 Objectives: The study's objective was to use a virtual reality system to enhance upper limb strength and function in hemiparesis. The study's secondary goal was to lessen tension and anxiety in stroke Survivors. Methods: This research was experimental. A patient was chosen from UEM Hospital in Jaipur, Rajasthan, based on inclusion and exclusion criteria. Upper Extremity Functional Index (UEFI) and Depression Anxiety Stress Scale (DASS-21) were employed as outcome measures to evaluate the patients. Result: The outcome of the post-intervention data revealed that the Upper Extremity Functional Index (UEFI) had significant values of P.311. P .002 was used to determine the importance of the Depression Anxiety Stress Scale (DASS-21). That indicates that following the intervention, all outcome indicators showed a considerable improvement. Conclusion: The post-intervention values of the depression anxiety stress scale (DASS 21) and the upper extremity functional index (UEFI) both indicated a substantial improvement. In order to improve strength and upper limb functions following hemiparesis and to lessen tension and anxiety as a result of the handicap, a low-cost VR system might be employed.

The Brazilian-Portuguese version of the Upper Extremity Functional Index (UEFI): Translation, cross-cultural adaptation and measurement properties for Brazilian adults after a burn injury

ObjectivesTo translate, cross-culturally adapt, validate, verify the reliability and estimate the minimal detectable change (MDC) of the UEFI to Brazilian Portuguese (UEFI-Br) for burns. MethodsThe study was carried out with 131 Brazilian burn cases at two time points, at discharge and at the first outpatient follow-up (15–21 days after discharge) in a Burn Treatment Center. The adaptation process of the UEFI was based on international recommendations. The Burn Specific Health Scale-Brief-Br (BSHS-B-Br) was also applied in order to analyze construct validity of the UEFI-Br and distribution-based methods were used to estimate its MDC. ResultsIntra- and inter-rater reliability were good with ICC of 0.986 (CI 95 %: 0.98–0.99) and 0.969 (CI 95 %: 0.955–0.979), respectively, at discharge and 0.997 (CI 95 %: 0.996–0.998) and 0.987 (CI 95 %: 0.981–0.991), respectively, at the first outpatient follow-up appointment. We found good internal consistency with Cronbach’s α values of 0.987 and 0.996, respectively, at the two times. The SEM was 4.42 and 2.31 at the first and second time points, respectively. The UEFI-Br scores demonstrated strong correlation with the Burn Specific Health Scale-Brief-Br (BSHS-B-Br) function domain scores (r = 0.87–0.90). No significant correlation was found between UEFI-Br scores and participants’ characteristics. The MDC of the UEFI-Br lies between 11 and 13 points. ConclusionThe Brazilian version of the UEFI-Br, a useful tool to assess upper limb function and disability, is a valid and reliable tool for use with Brazilian burn survivors. The MDC for the instrument was determined to be 11–13 points.

The upper extremity functional index (UEFI): Italian validation in patients with Facioscapulohumeral muscular dystrophy

Purpose The aim of this study was to adapt the Upper Extremity Functional Index (UEFI) to an Italian population affected by Facioscapulohumeral muscular dystrophy (FSHD) by translating and validating this instrument in an Italian cohort. Materials and methods Five Italian FSHD patients were interviewed regarding the form and content of the translated instrument. Subsequently, fifty-two patients were recruited for the validation purpose by serially completing the UEFI-IT and a battery of clinical assessments and questionnaires. Finally, a subset of thirty-nine patients underwent test-retest reliability. Results The Italian translation of the UEFI was highly relevant to patients, had a level of test-retest reliability from “good” to “excellent” (ICC = 0.90 with 95% confidence interval between 0.82 and 0.95), and a satisfactory internal consistency (Cronbach’s alpha = 0.96). Participants confirmed the usefulness and clearness of the tool in cultural validity. In known group validity, the UEFI-IT was significantly lower in patients unable to walk (24.10 ± 11.33 vs 55.71 ± 13.98, p < .0001; AUC = 0.9631) and in patients with longer disease duration (43.43 ± 17.16 vs 58.14 ± 13.71, p = 0.0034; AUC = 0.7359). Finally, the concurrent validity showed strong associations between the UEFI-IT and motor assessments, pain perception, and quality-of-life evaluations. Conclusions Overall, the UEFI-IT is an appropriate, valid, and reliable outcome measure for Italian-speaking FSHD patients.

A Pilot Test of the Measures of the Greek Version of Upper Extremity Functional Index in Patients with Lateral Elbow Tendinopathy.

Lateral elbow tendinopathy (LET) is a common upper limb pathology in people involved in manual occupations. The upper extremity functional index (UEFI) was specifically designed to evaluate functional limitations in patients with upper limb pathology. The UEFI was developed in English and has been translated into several languages, including Greek. However, it has been assessed only in patients with shoulder pathology. Thus, the aim of this study was to pilot-test the Greek version of the UEFI (GV-UEFI) questionnaire and assess its measurement properties in patients with LET. Thirty patients with LET were recruited and asked to fill in the GV-UEFI twice and the disabilities of arm, shoulder, and hand questionnaire (DASH) once. The internal consistency and test-retest reliability were examined using Cronbach's alpha and the intraclass correlation coefficient (ICC). The standard error of measurement (SEM) and the minimum detectable change (MDC) were calculated and possible ground or ceiling effects were also examined. Convergent validity was evaluated with the Greek DASH using Pearson's correlation. Lastly, the unidimensionality of the scale was examined through principal component analysis to verify construct validity. Internal consistency was high for the GV-UEFI (Cronbach's a = 0.98) and test-retest reliability was excellent (ICC = 0.98). The SEM was 2.95 and the MDC was 6.85. Test-retest reliability of each item was good (ICC > 0.87). The correlation analysis demonstrated a strong correlation between the GV-UEFI and the DASH. No floor or ceiling effects were found. Principal component analysis verified the construct validity and the unidimensionality of the scale. The GV-UEFI was successfully tested in patients with LET. It seems that the GV-UEFI can be used reliably in Greek-speaking patients with LET. However, the measurement properties of this scale should be examined in a larger sample of LET patients.

Responsiveness of the Arabic Upper Extremity Functional Index in Patients with Upper Extremity Musculoskeletal Disorders.

The aim of this study was to examine the ability of the Arabic Upper Extremity Functional Index (UEFI) to detect change over time in upper extremity function (responsiveness) in patients with upper extremity musculoskeletal disorders. Patients receiving physical therapy care for their upper extremity musculoskeletal disorders completed the Arabic UEFI; Disabilities of the Arm, Shoulder and Hand (DASH); Numeric Pain Rating Scale (NPRS); Global Assessment of Function (GAF); and the Global Rating of Change Scale (GRC) at the initial visit and later at a follow-up assessment. Responsiveness was examined by testing predefined hypotheses regarding the correlations between the change scores in the Arabic UEFI and the other measures. The Arabic UEFI change scores demonstrated a significant positive correlation with the change in the DASH (r = 0.94), GAF (r = 0.65), NPRS (r = 0.63), and GRC (r = 0.73), which was in line with the predefined hypotheses. The Arabic UEFI change scores demonstrated a pattern of correlation with changes in other outcome measures that are consistent with the argument that the Arabic UEFI change scores represent a change in upper extremity function. The responsiveness of the Arabic UEFI was supported, and its use to monitor changes in upper extremity function in patients with upper extremity musculoskeletal disorders was supported.

Work Related Upper Limb Musculoskeletal Disorders among Dentist; A Cross-Sectional Study with site and onset of Upper Limb Symptoms

Dentists' working day involves awkward and static standing and sitting positions to work within a precise mouth area, resulting in musculoskeletal problems. Objective: To determine frequency of musculoskeletal pain and disorders along with the body-site–specific upper limb (UL) symptoms among dentists. Methods: A cross-sectional study with non-probability convenience sampling was done from March to December 2021. Data were collected using three validated questionnaires, Rapid Upper Limb Assessment (RULA), Visual Analog Scale (VAS) and Upper Extremity Functional Index (UEFI). SPSS was used to analyze data. Results: Fifty-three dentists were enrolled, with 5 (9.4%) males and 48 (90.6%) females. Pain regions were assessed in terms of frequency and severity of pain. There were significant differences found in different regions with p-value less than 0.001. Severe pain was found more in elbow with 42.9%, moderate pain in shoulder was observed with 37.5% however, 31.8% mild pain was observed in neck region with significant p-value of 0.004. Mean Posture Score (Neck, Shoulder, Elbow and Wrist) was found to be 5.32 ± 0.85 and Mean Posture Score (Upper Back) was found to be 4.08 ± 1.68. Female Gender was found common 25.8% in neck pain, 20.9% in shoulder pain, 16.1% in elbow, 12.9% in upper back with significant p-value of 0.016. Conclusions: Elbow was the most painful area in upper limb among dentists working with Clients. Female were more vulnerable in pain than male and majority reported pain related problem, which results in restricted range of motion

Evaluating the effects of two different kinesiology taping techniques on shoulder pain and function in patients with hypermobile Ehlers-Danlos syndrome.

Ehlers-Danlos Syndrome (EDS) is a group of inherited connective tissue disorders which predominantly affects women and has a prevalence as high as 1 in 5,000 individuals. Hypermobile EDS (hEDS) is the most common subtype of EDS and is characterized by multi-joint pain, particularly in large joints such as the shoulder. Physical therapy is often utilized to address the pain, physical impairments, and functional loss in patients with EDS. Kinesiology Tape (KT) is an intervention commonly used by physical therapists for treating shoulder pain and dysfunction. Studies related to the effectiveness of KT in patients with shoulder pain is equivocal and there are a lack of studies specifically studying the effects of KT in an EDS population. The purpose of this study was to assess the efficacy and short-term effects of two different KT techniques on shoulder pain and function in individuals with hEDS and shoulder pain. Participants were recruited from EDS support groups in the New England area of the United States; were diagnosed with hEDS by their physician; and had shoulder pain. Baseline demographic information was obtained for each participant followed by completion of 4 patient reported outcome (PRO) measures: the Upper Extremity Functional Index, QuickDASH (Disabilities of the Arm, Shoulder, & Hand), Shoulder Pain and Disability Index, and the Western Ontario Shoulder Instability Index. Current pain level, average pain over the past 24 h, and worst pain over the past 24 h were recorded using the numeric pain rating scale (NPRS). Subjects were randomly assigned to receive either an experimental shoulder KT procedure or a control shoulder taping. Immediately after taping, the NPRS was reassessed. Subjects then returned 48 h later to repeat the NPRS and PRO measures. There was no significant difference between the experimental and control tape groups for any outcome measure. There was a significant improvement from pre-taping to 48-hours post taping for each of the 4 PRO measures with large effect sizes (p < 0.001; ƞ p 2 = .517-.719). Likewise, average, and worst pain over the last 24 h significantly improved with large effect sizes over the same period (p = 0.005; ƞ p 2 = .225 and p < 0.001; ƞ p 2 = .382, respectively). Current NPRS levels significantly improved from pre-tape to immediately post-tape (p = .023, ƞ p 2 = .131) and was maintained through the 48-hour follow up, although no further improvement was seen. KT is an inexpensive and relatively safe intervention that is easy to apply and can offer temporary improvements in pain and function for patients with EDS and shoulder pain.

Cross-Cultural Adaptation, Reliability, and Validity of the Greek Version of the Upper Extremity Functional Index.

Introduction The Upper Extremity Functional Index (UEFI) is a region-specific questionnaire for patients with upper extremity disorders including patients with rotator cuff-related pain (RCRP). We aimed to translate and cross-culturally adapt the UEFI into Greek (UEFI-Gr) and evaluate its reliability and validity in a Greek-speaking population with RCRP. Methods Published guidelines for translation and cross-cultural adaptation of patient-rated outcome measures were followed. One hundred two patients were asked to complete the Greek versions of the UEFI; Disability of the Arm, Shoulder, and Hand (DASH) questionnaire; and RAND 36-Item Health Survey. Internal consistency, test-retest reliability, measurement error, content validity, concurrent validity, and ceiling and floor effects were evaluated. Results Minor linguistic discrepancies were identified and adopted in the Greek language. The UEFI-Gr presented high internal consistency (Cronbach's alpha: 0.93), excellent test-retest reliability (intraclass correlation coefficient: 0.91; 95% confidence interval {CI}: 0.79-0.95), and acceptable measurement error (standard error of measurement: 4.9 points; minimal detectable change {MDC}: 13.8 points). No ceiling or floor effects were detected. Strong correlations were found with the Greek versions of the Disability of the Arm, Shoulder, and Hand questionnaire (r=0.629; p<0.001) and weak to moderate correlations with most subdomains of RAND 36-Item Health Survey (r=0.30-0.59; p<0.05). Conclusions The UEFI-Gr is a comprehensive, reliable, and valid self-reported instrument to evaluate symptoms in patients with RCRP. Further research on the responsiveness of the questionnaire is necessary.

The Upper Extremity Functional Index (UEFI): Cross-Cultural Adaptation, Reliability, and Validity of the Italian Version

The Upper Extremity Functional Index (UEFI): Cross-Cultural Adaptation, Reliability, and Validity of the Italian Version

Telephone-based joint protection education in lateral epicondylitis: A randomized controlled trial.

Lateral epicondylitis (LE) can occur for many different reasons such as compelling repetitive movements in daily readings, incorrect posture use and work-related factors. Although several treatments are available for LE, the optimal evidence-based treatment remains uncertain. Joint protection techniques have been developed as a self-management intervention to reduce pain and disability and improve functionality by applying ergonomic approaches. This study aimed to investigate the effects of telephone-based follow up on top of a home-based joint protection education programme on pain and functionality in individuals with LE. Individuals were randomly assigned into 2 groups; 1) telephone-based group, receiving telephone-based follow-up on top of a home-based joint protection education programme, and 2) home-based group, receiving home-based joint protection education alone. Both groups were given training that increased awareness in LE and home-based exercise programme. In addition, telephone-based group was followed up by telephone three days a week for four weeks. Improvements from baseline to 4th week in Turkish version of the Patient-Rated Tennis Elbow Evaluation-pain (p = 0.001; effect size = 1.11) and function (p < 0.001; effect size = 1.77), Upper Extremity Functional Index (p = 0.001; effect size = 0.85) and The Turkish version of the Joint Protection Behavior Assessment-Short Form (p < 0.001; effect size = 1.54) in the telephone-based group were significantly higher than the improvements in the home-based group. Telephone-based follow-up in individuals with LE contributed to the awareness of pain, functionality and joint protection methods. Telephone-based joint protection education programmes can offer a health service within the scope of preventive and protective intervention programmes for LE.

EFFECT OF MIRROR THERAPY VERSUS REPETITIVE FACILITATION EXERCISE ON UPPER LIMB FUNCTION IN POST STROKE PATIENT

Objective: To compare the effects of task-based mirror therapy and Repetitive Facilitation Exercise on upper limb function in post stroke patient. Methodology: A randomized controlled trial was conducted in Pakistan Railway general hospital, Rawalpindi. The duration of this study was from 10th July to 31st December 2019. Non-probability purposive sampling technique was used with n=50 male and female subacute and chronic post-stroke patients between 40-50 years. The patients with Modified Ashworth Scale &lt;3 and the first-ever stroke was included. The participants were randomly divided by the sealed envelope method into mirror therapy group (n=25) and Repetitive Facilitation Exercise group (n=25). The Upper extremity functional index (UEFI) was used to assess the functional impairment in individuals with upper limb dysfunction, Fugl Meyer (FMA-UE) for assessment of activity in post stroke patients, “Wolf Motor Function Test (WMFT) for upper extremity performance and functional capability” and Brunnstrom recovery scale (BRS) for motor function of the upper limb was used in a post stroke patient. All the patients were assessed at baseline than after 3 weeks and again after 6week for interventional session of 30 min,3 days of the week. Data were analyzed through SPSS version 23. Results: The mean age of Group A (MT) was 50.97±6.741 and 49.76±12.66 of Group B (RFE). After 6 weeks of intervention between groups analysis of Task-based mirror therapy showed significant improvement in mirror therapy group as compare to Repetitive Facilitation Exercise group ,for upper extremity functional index scores(p&lt;0.001) but for motor assessment(FMA-UE), Wolf Motor Function Test (WMFT) and for stroke recovery (Brunnstrom) no statistically significant difference (p≥0.05) was found. Within-group analysis of both groups showed statistically significant results in all variables (p&lt;0.001). Conclusion: Mirror therapy and Repetitive facilitation Exercise both were found to be effective in improving upper limb motor functions of acute stroke patients. However, Mirror therapy has shown significant effects in upper extremity functional index. Keywords: Mirror therapy, Physical therapy, Repetitive Facilitation Exercise, Stroke, Upper extremity.

Occupational engagement, fatigue, and upper and lower extremity abilities in persons with melorheostosis.

Melorheostosis is a rare bone disorder with limited literature that describes the effect of this disease on functional and motor abilities. As part of a natural history study, four outcome measures were administered to better understand the burden this disease has on a person's ability to engage in basic and instrumental activities of daily living. To investigate the relationship between functional engagement, fatigue, and motor ability in patients with melorheostosis. Cross-sectional data gathered from a longitudinal natural history observational study. Rehabilitation department within a single institution. Forty-seven adult volunteers with melorheostosis were enrolled. Two participants were removed for failure to meet diagnosis eligibility. Thirty patients had lower extremity (LE) osteosclerotic bone lesions, 14 had upper extremity (UE) lesions, and one had lesions in both UEs and LEs. Not applicable. Activity Card Sort, Second Edition (ACS); Multi-Dimensional Fatigue Inventory; Lower Extremity Functional Scale; Upper Extremity Functional Index. On the ACS, high-demand leisure (HDL) activities were the least retained (p < .001). Of the activities rated most important, HDL activities were the most likely to have been given up (27%). General fatigue (μ=11.8) and physical fatigue (μ=11.0) were the two most limiting fatigue constructs. There were moderate negative correlations with HDL activities compared to physical fatigue (r=-0.524, p < .001) and reduced activity fatigue (r=-0.58, p=.001). LE lesions had a large effect on completing LE tasks (d=0.95) and UE lesions had a medium effect on completing tasks involving the UE (d=0.69). Patients with melorheostosis experience fatigue and low engagement in HDL activities. The results of this study underscore the importance of acknowledging activity domain, fatigue constructs, and lesion location to support and provide targeted evidence-based rehabilitative therapy. NCT02504879.

Does subscapularis integrity influence outcome following latissimus dorsi tendon transfer for irreparable cuff tears? A comparative series of 48 patients

BackgroundLatissimus dorsi tendon transfer (LDTT) remains a surgical option for massive irreparable rotator cuff tears. Despite a lack of comparative studies, subscapularis insufficiency has been reported as a contraindication. This study investigated the clinical outcome at a minimum 2-years post-surgery, in patients undergoing LDTT with varied subscapularis integrity. MethodsThis retrospective study included 48 patients, of which 22 underwent LDTT with an intact subscapularis (age 56.9 years, review time 79.6 months, males 68.2%) and 26 with partial (16 patients) or full-thickness (10 patients) subscapularis tearing (age 57.4 years, review time 73.3 months, males 73.1%) between 2004 and 2018. Pre-operative imaging ascertained subscapularis status. Outcomes included the Upper Extremity Functional Index (UEFI), Global Rating of Change (GRC) and patient satisfaction. ResultsNo significant group differences were observed in age (p = 0.617) or review time (p = 0.555), nor the UEFI (intact 69.6, not intact 67.0, p = 0.265) or GRC (intact 3.6, not intact 2.9, p = 0.265). High levels of patient satisfaction were observed in both groups for pain relief, improving the ability to undertake daily and recreational activities, and overall satisfaction (intact 95.5–100.0%, not intact 92.3–96.2%). ConclusionLDTT resulted in encouraging clinical scores and high satisfaction levels, irrespective of the degree of untreated, underlying subscapularis integrity. Level of evidenceTherapeutic Level III.

Robotic Table and Serious Games for Integrative Rehabilitation in the Early Poststroke Phase: Two Case Reports.

BackgroundBrightArm Compact is a new rehabilitation system for the upper extremities. It provides bimanual training with gradated gravity loading and mediates interactions with cognitively challenging serious games.ObjectiveThe aim of this study is to design and test a robotic rehabilitation table–based virtual rehabilitation system for functional impact of the integrative training in the early poststroke phase.MethodsA new robotic rehabilitation table, controllers, and adaptive games were developed. The 2 participants underwent 12 experimental sessions in addition to the standard of care. Standardized measures of upper extremity function (primary outcome), depression, and cognition were administered before and after the intervention. Nonstandardized measures included game variables and subjective evaluations.ResultsThe 2 case study participants attained high total arm repetitions per session (504 and 957) and achieved high grasp and finger-extension counts. Training intensity contributed to marked improvements in affected shoulder strength (225% and 100% increase), grasp strength (27% and 16% increase), and pinch strength (31% and 15% increase). The shoulder flexion range increased by 17% and 18% and elbow supination range by 75% and 58%. Improvements in motor function were at or above minimal clinically important difference for the Fugl-Meyer Assessment (11 and 10 points), Chedoke Arm and Hand Activity Inventory (11 and 14 points), and Upper Extremity Functional Index (19 and 23 points). Cognitive and emotive outcomes were mixed. Subjective rating by participants and training therapists were positive (average 4, SD 0.22, on a 5-point Likert scale).ConclusionsThe design of the robotic rehabilitation table was tested on 2 participants in the early poststroke phase, and results are encouraging for upper extremity functional gains and technology acceptance.Trial RegistrationClinicalTrials.gov NCT04252170; https://clinicaltrials.gov/ct2/show/NCT04252170

Remote Working and Its Impact on Upper Extremities

&lt;p&gt;&lt;strong&gt;Aim:&lt;/strong&gt; The current investigation was to examine the intensity of pain in upper limbs experienced by the remote workers.&lt;strong&gt; Methods:&lt;/strong&gt; A questionnaire was developed which includes demographic profile sheet, work profile sheet and upper extremity functional index. These tools were used to gather information from the respondents. Google forms links of the questionnaire were mailed to 500 respondents and of which 198 people have responded. This paper focused on the intensity of pain due to prolonged sitting, working from home without any proper workplace. &lt;strong&gt;Result:&lt;/strong&gt; The pain was common among all the ages of respondents but it was little more in the male and also the pain is present in all the professions. &lt;strong&gt;Conclusion:&lt;/strong&gt; The recent pandemic has put more stress on people regarding work from home, online working while sitting, a little of walking. It has impacted people’s physical well-being by developing different type of pain in the body.&lt;/p&gt;